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Table 2 Multivariate generalized estimating equation model† to examine the association between the predictor variables and healthcare utilization, and use of medication

From: Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India

Variable

Incomplete utilization of healthcare

Inaccessibility to health care

Inaccessibility to healthcare due to supply-side factors

Inaccessibility to healthcare due to demand-side factors

Non-adherence to medication

Non-adherence to medication due to supply-side factors

Non-adherence to medication due to demand-side factors

 

OR (95% CI)

OR (95% CI)

OR (95% CI)

OR (95% CI)

OR (95% CI)

OR (95% CI)

OR (95% CI)

Afghanistan

Environmental factor

Initial phase of COVID-19 outbreak

0.7 (0.6,0.9)*

0.8 (0.8,0.9)*

1.0 (0.8,1.2)

0.9 (0.7,1.1)

1.7 (1.6,1.9)*

0.8 (0.7,0.9)*

1.4 (1.1,1.7)*

After one year of COVID-19 outbreak

0.9 (0.7,1.1)

1.1 (0.9,1.3)

1.5 (1.1,2.0)*

0.2 (0.1,0.4)*

0.7 (0.6,0.9)*

0.7 (0.5,0.9)*

1.1 (0.7,1.7)

Pre-disposing factors

       

26 years and above

1.0 (0.8,1.3)

1.0 (0.8,1.2)

0.8 (0.6,1.0)

1.1 (0.8,3.4)

0.7 (0.6,0.9)*

0.9 (0.7,1.2)

1.07 (0.7,1.5 )

Male

0.8 (0.6,1.1)

0.8 (0.6,1.0)

1.3 (0.9,1.8)

0.7 (0.5,1.0)

1.1 (0.9,1.4)

1.3 (0.9,1.9)

0.6 (0.3,1.02)

Less than tertiary education

0.9 (0.7,1.1)

1.1 (0.9,1.2)

1.2 (1.02,1.5)*

0.8 (0.6,1.0)

1.1 (0.9,1.2)

1.3 (1.1,1.7)

0.7 (0.5,1.07)

Large household

0.8 (0.7,1.0)

0.4 (0.4,0.5)*

0.4 (0.3,0.5)*

2.4 (1.9,3.0)*

0.9 (0.7,1.0)

0.3 (0.2,0.4)*

4.0 (2.8,5.9)*

Enabling/disabling factors

       

Rural

0.8 (0.6,0.9)*

0.7 (0.6,0.8)*

0.9 (0.7,1.1)

1.0 (0.8,1.3)

1.4 (1.2,1.6)*

1.0 (0.8,1.3)

0.7 (0.5,1.0)

Poor financial status

0.8 (0.7,1.0)

0.8 (0.7,1.0)

1.2 (1.02,1.5)*

0.8 (0.6,1.0)

0.9 (0.8,1.1)

1.3 (1.02,1.6)*

0.8 (0.6,1.1)

Not participating in an income-generating activity

2.1 (1.8,2.5)*

1.8 (1.6,2.1)*

0.9 (0.7,1.1)

1.1 (0.8,1.3)

0.4 (0.4,0.5)*

0.5 (0.4,0.7)*

1.7 (1.3,2.2)

Income

0.9 (0.9,0.9)*

0.9 (0.9,0.9)*

0.9 (0.9,0.9)*

1.0 (1.0,1.09)

0.9 (0.9,1.0)

0.9 (0.9,1.0)

1.0 (0.9,1.0)

Need for care factor

       

Need assistance in managing NCDs

0.9 (0.7,1.1)

1.1 (0.9,1.3)

1.2 (1.01,1.6)*

0.7 (0.5,0.8)*

1.5 (1.3,1.8)*

1.4 (1.07,1.9)*

0.3 (0.2,0.4)*

Bangladesh

Environmental factor

       

Initial phase of COVID-19 outbreak

3.7 (1.4,9.4)*

2.0 (1.1,3.7)*

1.1 (0.4,3.0)

0.8 (0.3,2.1)

1.1 (0.8,1.7)

2.3 (1.3,4.1)*

0.4 (0.3,0.8)*

After one year of COVID-19 outbreak

1.1 (0.2,5.5)

1.4 (0.5,3.9)

2.8 (0.6,12.5)

0.1 (0.03,0.6)*

1.5 (0.6,3.7)

0.5 (0.1,1.7)

1.7 (0.5,5.6)

Pre-disposing factors

       

26 years and above

2.5 (1.05,6.2)*

1.8 (0.8,3.9)

0.2 (0.06,1.3)

3.5 (0.7,17.5)

1.5 (0.5,2.1)

0.9 (0.3,2.5)

1.1 (0.3,3.4)

Male

0.4 (0.06,2.5)

0.7 (0.2,2.5)

-

-

0.8 (0.2,2.5)

1.3 (0.2,6.1)

3.1 (0.4,21.1)

Less than tertiary education

0.8 (0.3,2.2)

0.8 (0.3,1.9)

2.5 (0.6,9.3)

0.4 (0.1,1.7)

1.0 (0.5,2.1)

0.4 (0.1,1.7)

1.9 (0.5,6.9)

Large household

1.3 (0.5,3.6)

1.2 (0.6,2.5)

0.9 (0.2,3.4)

1.1 (0.3,4.3)

0.9 (0.4,1.7)

0.2 (0.09,0.7)*

3.0 (1.1,8.4)*

Enabling/disabling factors

       

Rural

0.4 (0.1,1.2)

0.5 (0.2,1.1)

0.4 (0.1,1.5)

2.0 (0.5,7.8)

1.3 (0.6,2.5)

1.6 (0.6,4.7)

0.7 (0.2,2.2)

Poor financial status

2.6 (0.8,8.2)

1.4 (0.6,3.3)

0.6 (0.1,3.5)

1.3 (0.2,7.8)

0.6 (0.2,1.4)

2.7 (1.003,7.5)*

0.3 (0.1,0.8)*

Not participating in an income-generating activity

1.1 (0.4,2.9)

1.5 (0.7,3.2)

0.6 (0.2,2.2)

1.8 (0.5,6.3)

0.6 (0.3,1.0)

0.6 (0.2,1.6)

0.9 (0.3,2.4)

Income

1.1 (0.9,1.4)

0.9 (0.7,1.0)

0.8 (0.6,1.1)

0.3 (0.09,1.3)

1.0 (0.8,1.1)

1.1 (0.9,1.5)

0.8 (0.7,1.1)

Need for care factor

       

Need assistance in managing NCDs

0.7 (0.2,2.0)

1.3 (0.6,2.9)

2.1 (0.5,7.5)

0.3 (0.09,1.3)

3.7 (1.9,7.3)*

3.4 (0.8,14.1)

0.1 (0.04,0.8)*

India

Environmental factor

Initial phase of COVID-19 outbreak

0.8 (0.5,1.3)

0.9 (0.6,1.1)

1.4 (0.8,2.4)

0.6 (0.4,1.1)

1.3 (1.1,1.7)*

0.9 (0.6, 1.4)

0.9 (0.6,1.3)

After one year of COVID-19 outbreak

0.6 (0.2,1.5)

0.8 (0.4,1.3)

1.5 (0.6,3.6)

0.09 (0.02,0.4)*

1.0 (0.5,1.6)

2.7 (1.1,6.5)*

0.1 (0.06,0.3)*

Pre-disposing factors

       

26 years and above

0.9 (0.5,1.6)

0.8 (0.6,1.2)

1.1 (0.6,1.9)

0.8 (0.4,1.4)

1.2 (0.8,1.9)

0.3 (0.1,0.6)*

2.3 (1.1,4.8)*

Male

1.2 (0.6,2.2)

1.0 (0.7,1.6)

1.0 (0.6,1.9)

0.8 (0.4,1.4)

1.1 (0.7,1.8)

1.3 (0.5,2.8)

0.6 (0.2,1.6)

Less than tertiary education

1.3 (0.7,2.1)

1.1 (0.7,1.6)

1.1 (0.6,1.8)

0.8 (0.5,1.3)

1.2 (0.8,1.7)

0.9 (0.4,1.6)

1.4 (0.7,2.8)

Large household

0.7 (0.4,1.2)

0.6 (0.4,0.9)*

0.5 (0.2,0.9)*

1.8 (1.07,3.2)*

0.7 (0.4,1.0)

0.3 (0.1,0.6)*

2.6 (1.3,5.2)*

Enabling/disabling factors

       

Rural

1.0 (0.6,1.7)

1.0 (0.7,1.4)

1.4 (0.8,2.4)

0.7 (0.4,1.1)

1.6 (1.1,2.3)*

1.1 (0.6,2.1)

0.8 (0.4,1.6)

Poor financial status

1.4 (0.8,2.4)

1.0 (0.7,1.3)

0.6 (0.3,1.02)

1.6 (0.9,2.7)

1.4 (1.02,2.0)*

0.9 (0.4,1.7)

1.1 (0.5,2.4)

Not participating in an income-generating activity

2.0 (1.2,3.5)*

1.7 (1.2,2.4)*

0.8 (0.4,1.3)

1.1 (0.6,1.9)

0.3 (0.2,0.4)*

0.3 (0.1,0.6)*

2.2 (1.1,4.3)*

Income

0.9 (0.8,1.0)

1.0 (0.9,1.0)

0.9 (0.8,1.0)

1.0 (0.9,1.1)

1.0 (0.9,1.0)

0.9 (0.8,1.0)

0.9 (0.9,1.0)

Need for care factor

       

Need assistance in managing NCDs

1.2 (0.7,2.1)

1.0 (0.7,1.5)

1.1 (0.6,1.9)

0.8 (0.4,1.4)

2.3 (1.4,3.6)*

2.3 (1.1,4.6)*

0.3 (0.1,0.7)*

  1. * p value < 0.05
  2. †All covariates were mutually adjusted
  3. Reference group for Impact of COVID = “Pre-COVID phase”, gender = female, age = less than 26 years, education = less than tertiary education, household size = Small household, residence = urban, financial status = better financial status, income generating activity = participated in income-generating activity, and need for care factors = those who sought assistance in managing communicable diseases only
  4. Abbreviations: OR, Odds Ratio; CI, Confidence Interval; NCDs, Non-communicable diseases
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